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The Multiple Sclerosis Performance Test MSPT: An iPad-Based Disability Assessment Tool
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Disease-Modifying Treatment in Progressive Multiple Sclerosis.

John Robert Ciotti1, Anne Haney Cross2,3

  • 1Washington University in St. Louis, St. Louis, MO, USA.

Current Treatment Options in Neurology
|April 9, 2018
PubMed
Summary

New treatments offer hope for progressive multiple sclerosis (MS). Ocrelizumab and siponimod show promise in slowing disability progression and brain atrophy in primary and secondary progressive MS patients.

Keywords:
Disease-modifying therapyNeuroprotectionProgressive multiple sclerosisRemyelination

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Area of Science:

  • Neurology
  • Immunology
  • Clinical Trials

Background:

  • Multiple sclerosis (MS) is a CNS disorder affecting young adults, with subtypes including relapsing-remitting (RRMS), secondary progressive (SPMS), and primary progressive (PPMS).
  • Limited disease-modifying treatments (DMTs) are available for progressive MS (PPMS and SPMS) compared to relapsing forms.
  • Progressive MS is characterized by chronic progression, differing from the inflammatory nature of RRMS.

Purpose of the Study:

  • To define progressive MS (PPMS and SPMS).
  • To review major clinical trials for progressive MS.
  • To outline potential management strategies for progressive MS.

Main Methods:

  • Review of clinical trial data for DMTs in progressive MS.
  • Analysis of treatment outcomes, including disability progression and brain atrophy.
  • Examination of emerging therapeutic agents and outcome measures.

Main Results:

  • Ocrelizumab, a B lymphocyte-depleting antibody, demonstrated a 24% reduction in 12-week confirmed disability progression (CDP) in PPMS.
  • Siponimod, a sphingosine-1-phosphate receptor modulator, reduced 3-month CDP by 21% in SPMS.
  • Ibudilast, alpha-lipoic acid, and simvastatin showed potential in slowing brain atrophy in PPMS and SPMS patients.

Conclusions:

  • Recent advancements, including ocrelizumab and siponimod, provide optimism for progressive MS treatment.
  • Identifying outcome measures that reflect the degenerative pathology of progressive MS remains a challenge.
  • Further research is needed to optimize DMTs and management strategies for PPMS and SPMS.